Tactical Combat Casualty Care

TCCC

SPC OWENS
Introduction
The Tactical Combat Casualty Care
was developed in 1996 by special
forces operation. Tactical Combat
Casualty Care guidelines are
evidence-based and battle eld-
proven to reduce deaths at the
point of injury. department of
defense and NATO allies required
TCCC training for deploying forces
because it combines e ective
tactics and medicine.
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Introduction
The Tactical Combat Casualty Care
was developed in 1996 by special
forces operation. Tactical Combat
Casualty Care guidelines are
evidence-based and battle eld-
proven to reduce deaths at the
point of injury. department of
defense and NATO allies required
TCCC training for deploying forces
because it combines e ective
tactics and medicine.
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TCCC teachers first responders to
treat casualties in proper order,
treating the most critical situations
first. This is done using the
acronyms for MARCH and PAWS
TCCC teachers first responders to
treat casualties in proper order,
treating the most critical situations
first. This is done using the
acronyms for MARCH and PAWS
MARCH
Massive Hemorrhage
MARCH
Massive Hemorrhage

• The number one potentially survivable cause of death at the POI is

hemorrhage from a compressible wound or any life-threatening extremity
bleed. More than 90% of 4,596 combat deals post 11 September 2001 died
of a hemorrhage associated injuries. Tourniquets are the recommended
management For all extremity hemorrhages during care under re it is initially
place over clothing, high and tight. Tourniquet is placed under clothing 2 to 3
inches of above wound.

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MARCH
AIRWAY
 MARCH
AIRWAY

• A second survival cause of death at the POI is a non-patent(closed) airway.

airway injuries typically occur from MAXILLOFACIAL trauma or inhalation
burns. A conscious and speaking casualty has patent open airway. an
unconscious casualty, who is breathing can bene t from nasopharyngeal
airway (NPA). an unconscious casualty, who is not breathing, may require a
de nitive airway such as a surgical CROTHYRORDOTOMY. In a combat
setting, endotracheal intubation is highly di cult, if not impossible.
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MARCH
RESPIRATIONS
MARCH
RESPIRATIONS

• The third potentially survivable cause of death on the battle eld is the
development of a tension pneumothorax (PTX). Air trapped in the chest cavity
begins to displace functional lung tissue and places pressure on the heart,
resulting in cardiac arrest. Seal open chest wounds with a vented chest seal
decompress, a suspected PTX and support ventilation oxygenation as
required. Treat a PTX via needle chest decompression using a 14 gauge 3.25
inch long deal with a catheter.

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March
Circulation
 March
Circulation

• Control over the bleeding takes print presidents over infusing uids. Only
individuals in shock or those who need IV medication‘s need to have IV access
established. Use an 18-gauge catheter and saline lock in a eld setting. Give
tranexamic acid (TXA) as soon as feasible to casualties in or at risk of
hemorrhagic shock. once a saline lock is established security with transparent
wound dressing lm. Administer uids by second needle and a catheter through
the lm dressing. When the infusion is complete, withdraw the needle leaving the
saline lock in place.
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MARCH
HEAD INJURY/HYPOTHERMIA
 MARCH
HEAD INJURY/HYPOTHERMIA

• Hypotension (systolic blood pressure under 90) and hypoxia ( peripheral

capillary oxygen saturation under 90) worsen secondary brain injury. Medical
personnel identify my traumatic brain injury using the Military acute concussion
evaluation (Aka mace-pocket-cards). Non-medical personnel utilize the alert,
verbal pain, unresponsive (AVPU) scale. Hypothermia is a survivable cause of
further injury and is de ned as a whole body temperature below 95 F (35 C).
Hypothermia can occur secondary to blood loss, regardless of the ambient
temperature.
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PAWS
PAIN
PAWS
PAIN

• Management of a casualties pain helps reduce stress on the mind in the

body. By managing pain from the POI on Ward casualties have reduced
incidents of post traumatic stress disorder, PTSD at Role 4 care
( rehabilitation) and beyond. Pain management reduces patient movement
improves compliance and cooperation, and allows for a better casualty
transport and outcomes.
PAWS
ANTIBIOTICS

• The recommended parental antibiotics for POI care are ertapenem, 1 gram or
cefotetan 2 grams. These antibiotics are used to treat multi drug resistant
bacteria. Ertapenem has been designed to be e ective against gram-negative
and gram positive bacteria. Cefotetan is a second generation
CEPHALOSPORIN and has a broad spectrum of activity. It has been used to
treat bacterial infections of the bone skin urinary tract and lower respiratory
tract. Moxi oxacin is a broad spectrum Quinolone antibiotic that can be
administered orally. All Butter eld wounds are considered contaminated. All
wound casualties with penetrating injuries should receive antibiotics.
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PAWS
WOUNDS
PAWS
WOUNDS

• Assessing and treating casualties with additional wounds, improve morbidity

and mortality. Minor scout lacerations can be the cause of excessive
hemorrhage. First responders must address, burns, open fractures, facial
trauma, amputation dressings, and security of tourniquets. Reassessment of
wound and interventions prior to movement is critical. When preparing the
patient for transport casualties, with penetrating trauma to the chest or
adamant, should be evacuated on a emergent basis, due to the possibility of
internal hemorrhage. Responders should give TXA, as soon as feasible to the
casualties in or at risk of hemorrhage shock.
PAWS
SPLINTING

• Medical personnel share address, pelvic disruptions and eye injuries. The
energy required to cause a lower extremity traumatic amputation ( from an
improvise explosive device, land mine, etc.) moves upward through the body
potentially causing further bone disruption, hollow organ collapse, or internal
bleeding. Respond to should use the combat ready clamp the junctional
emergency treatment tool, or the Sam junctional tourniquet to control,
junctional hemorrhage and stabilize the pelvis. Splinting of fractures can result
in signi cant pain, relief, and minimize bleeding. In case of suspected,
penetrating eye, trauma responder, should 1.) perform a rapid eld test a
visual, acuity.; 2.) tape, a rigid shield over the eye to prevent further trauma to
the eye; and 3.) give antibiotics by mouth as soon as possible to prevent
infection inside the eye, never apply pressure dressing to, and I with a
suspected penetrating injury
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Questions